SAGES: early gastric cancer

Early gastric and esophageal cancer is rare with adeno. But much higher in scc. T1a n0 0% vs. ?50%

T1 n1 cancer. What is proper surgery?
Total gastrectomy.

Superficial esophageal cancer. T1b associated with 20% LN mets. Even pts with N0 disease can be associated with recurrent metastatic disease. Morphology and poorly differentiated associated with higher recurrence.

Endoscopic mucosal resection of superficial esophageal cancer. Consider as A big biopsy. May be more accurate then conventional eus
- high frequency eus may be better at characterizing depth of onvason butnoy universially available.

Hulscher nejm 2002: trans thoracic vs trans hiatal esophagectomy.
- siewart classification


- principles of esophageal cancer surgery.
- what is the risk of Ln mets?
- if low, resection techinque does not need to focus on ln retrieval (trans hiatal may be an option) but how much do you trust your preop t staging sensitivity?
- if high look for techiniqye that yields more ln- ie trans thoracic technique.




- Posted from iPhone